Monday, November 28, 2016

Essure Contraception to Come With a Warning

Not mentioned in Human Biology: Concepts and Current Issues is a type permanent non-surgical contraception for women marketed by Bayer, called Essure.  Essure consists of a pair of small coiled devices placed in the two fallopian tubes through the vagina.  The devices trigger local inflammatory responses that seal off the fallopian tubes within about 3 months, rendering the woman permanently sterile.  When it was first approved in 2002, Essure became the first permanent sterilization procedure that could be done in a doctor's office without general anesthesia or a surgical incision, making it an attractive option to surgical tubal ligation for some women.

Now it appears that Essure will come with an FDA-mandated warning that it may cause unwanted effects in some women, including possible puncture of the fallopian tubes or uterus and intense pain.  The FDA is not requiring that the devices be pulled from the market at this time because the device has been proven safe and effective for most women.  However, the FDA did work with Bayer to develop a 3-page checklist that physicians and patients may find useful in evaluating the risks and benefits of Essure versus surgical tubal ligation.

Bayer, of course, blames any problems associated with Essure on poor skills on the part of doctors implanting the devices.  There could be some truth to that. For most medical procedures, physicians who have done a lot of them tend to have fewer reported complications.  It's always wise to choose your physician carefully.

Tuesday, November 15, 2016

Vice-President-Elect Mike Pence Says "Smoking Doesn't Kill"

The U.S. will soon have a Vice-President who denies the health dangers of smoking cigarettes. The Former Indiana governor and U.S Congressman has consistently argued that there is no causal link between smoking and lung cancer. In 2000 he wrote, "Time for a quick reality check. Despite the hysteria from the political class and the media, smoking doesn't kill." He has yet to change his position.

The Surgeon General of the United States clearly identified the risks associated with smoking in a report released back in 1964. Since then, nearly all states have set up smoking cessation programs. Mike Pence cut funding for Indiana's smoking cessation program when he was Indiana's governor while receiving generous campaign contributions from the tobacco industry, according to a ThinkProgress investigative report.

You can't dismiss away overwhelming scientific evidence just because it isn't politically expedient. Smoking does kill, Mr. Vice-President-Elect.

Friday, November 11, 2016

Medical Abortions Without Visiting an Abortion Clinic

A study is underway in four states (Hawaii, Washington, Oregon, and New York) to determine whether medical abortions can be conducted safely without the woman ever having to visit an abortion clinic.

Currently, women must visit to an abortion clinic for a medical abortion.  After consultation with a physician, the woman is prescribed two pills; the first is given at the abortion clinic, and the second is taken a day later.  Together, the two pills cause a miscarriage.  Medical abortions are FDA-approved during the first 10 weeks of pregnancy; after that, only surgical abortions are allowed.   Nearly a quarter of all abortions in the U.S. are now medical abortions.

In the current study, women will first consult with an abortion provider by video, from the comfort of her own home.  Then certain tests must be completed, including blood work and an ultrasound.  If all goes well, the medical abortion pills will be delivered by mail.

The FDA has approved the study and will be monitoring the safety of the procedure closely.  But pro-life advocates are unlikely to favor FDA approval of medical abortions by videoconference and mail, regardless of how safe it turns out to be.

Monday, November 7, 2016

An Increase in Suicides Among Young Adolescents

From 2007 to 2014 (the last year for which data are available) the suicide rate among young adolescents aged 10 to 14 doubled, according to the Centers for Disease Control and Prevention (CDC). In 2014 there were 425 deaths from suicide in this age group. And for the first time, the number of deaths by suicide among young adolescents exceeded the number of deaths from auto accidents, which has been declining in recent years.

The trend is disturbing, but for now a cause (or causes) has not been identified. Officials speculate that one factor may be the rise of social networking, which enables bullying to be witnessed not just by a close group of friends or classmates, but the whole school and even the wider community, magnifying the shame and unhappiness of the victim. And with 24-hour access to the social networking, bullying does not necessarily end after school.

It's something to think about. Is there anything we might do to reverse this trend?

Thursday, November 3, 2016

Bioengineered Tobacco Plants Produce an Antimalarial Drug

One of the main weapons against malaria, a drug called artemisinin, comes from a plant called sweet wormwood. Unfortunately sweet wormwood grows slowly and the yield of artemisinin per plant is low. In addition, extraction of the drug is difficult and expensive. As a result, the supply of purified artemisinin is currently insufficient to meet worldwide demand.

That's where genetic engineering may come to the rescue. Researchers have managed to insert 12 key genes in the artemisinin biosynthetic pathway into tobacco plants. The modified tobacco plants grow quickly and produce much more artemisinin per gram of dried leaf than sweet wormwood. Indeed, they produce so much artemisinin that just feeding the dried leaves directly to malaria-infected mice works as well against malaria as administering purified artemisinin. The researchers suggest that by creating genetically modified plants that produce high concentrations of artemisinin, extraction and purification of the drug may not be necessary at all.

No one is suggesting that it would be a good idea to feed malaria-infected kids a steady diet of dried tobacco leaves. But as a proof of concept, these new findings demonstrate that it might be possible to genetically engineer another plant to produce artemisinin. Perhaps some day the drug will be produced in an edible plant, such as beets or lettuce.